07-106926City of Federal Way
Community Development Services
P.O. Box 9718
Federal Way, WA 98063 -9718
Ph: (253) 835 -2607 Fax: (253) 835 -2609
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Mechanical Permit #: 07- 106926 -00 -ME
Project Name: PICARD s
Project Address: 2002 SW 307TH ST
i
Inspection Request Line: (253) 835 -3050
Project Description: Install gas fireplace insert and run associated gas piping.
Parcel Number: 770380 0340
Owner
Applicant
Contractor
NADINE PICARD
KLIEMANN BROTHERS HTG & A/C IN
KLIEMANN BROTHERS HTG & A/C IN
2002 SW 307TH ST
4703 116TH ST E
kliembh02lbt (1/27/08)
FEDERAL, WAY WA
TACOMA WA 98446
4703 116TH ST E
98023 -3441
TACOMA WA 98446
Additional Permit information
Mechanical Valuation ................. ...........................3317 Over the Counter Permit ? ...................................... Yes
Mechanical Fixtures
Fireplace Inserts ............................. 1 Gas Piping....... ............................... 1 Gas Pipe Outlets ............................ 1
PERMIT EXPIRES Monday, December 28, 2009
Permit Issued on Friday, December 28, 2007
1 hereby certify that the above information is correct and that the construction on the above described property and
-the occupancy and the use will be in accordance with the laws, rules and regulations of the State of Washington
n the City of Federal Way.
Owner or agent: Date:
THIS CARD IS TO REMAIN ON -SITE
CITY OF Community Development Inspection Record -
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835 -3050.
PERMIT #: 07- 106926 -00 -ME
Owner: NADINE PICARD
Address: 2002 SW 307TH ST
FEDERAL WAY, WA 98023
This card is part of your required inspection documents. Scheduled inspections may be failed if this card is not on -site. DO NOT LOSE THIS CARD.
Inspections are listed as close to sequential order as possible (read left to right, top to bottom). Please schedule inspections as appropriate. Work must not
be covered until it is approved. Check with your inspector if you are unsure about any of the inspections or the inspection sequence. On -going inspections
are logged on the back of this card.
❑ Mechanical Rough -in (4165) ❑ Gas Piping (4125) ❑ Final - Mechanical (4065)
Approved Approved to release test Approved
By Date By Date By G r-.J Date
For rector reference only
❑ Rough Electrical ❑ FINAL - Electrical
Approved Approved
By Date By Date
CITY OF _ 1 ® b ( `— _
-Federa[Way RECEIVED PERMIT u
COMMUNITY DEVELOPMENT SERVICES SF MF C . ME L PL DE EN FP
J3J2FEDERAL WAY, WA 98063-971 89718 DEC 2 8AP p L I C AT I O N T° -
253-835-2607-FAX 253- 835 -2609
• vnq_;.nt�l;ederr:huau. ccm
QTY OF F=EDERAL WAY
The following is requiregii4joiapi&DERTsn incomplete application will not be accepted. Please print legibly (in ink) or type.
PROPERTY •. •
SITE ADDRESS�� �� C SUITE /UNIT #
ASSESSOR'S TAX /PARCEL # - ` �7 LOT SIZE (s/)
�o
LEGAL DESCRIPTION (e.g. Acme Estates, Lot 1)
TYPE OF PERMIT
(Attach sepamte page for lengthy legal description)
PROJECT • •
❑ BUILDING ❑ PLUMBING 4ECHANICAL
❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
DESCRIPTION .(Provide detailed description of work included on this permit onlul
�k O\ r fry fir;. nq *)\ r I r 0 k Y-1,n, ,- V-)-, -
PROJECT NAME (Name of Business or Owner Last Name) %1 (N
PEOPLE •• •
PROPERTY
OWNER .
CONTRACTOR
COPY e
P [card rcgv d
with each applicatlo
APPLICANT
PROJECT
CONTACT
LENDER
NAME `�, �
PRIMARY PHONE
-
MAILING ADDRESS
CITY, STATE, ZIP
CITY, STATE, ZIP
E -MAIL ADDRESS
COMPANY NAME
APPLICANT NAME
O�FFFIICEE PHONE
MAILING ADDRESS
CITY, STATE, ZIP
CELL PHONE
MAI NG ADDRESS
CITY, STATE, ZIP
CELL PHONE
-
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER
EXPIRATION DATE
FAX NUMBER
�-00
(2- ?7 - 07
( ) -
NUM LEER/
CONTRACTOR'S REGI�ST�^R
EXPIRATION DATE
E -MAIL ADDRESS
\ATION
O P NA E
�;\ ANY lA VA Vbl` •
APPLICANT NAME
OFFICE PHONE
MAILING ADDRESS
CITY, STATE, ZIP
CELL PHONE
RELATIONSHIP TO PROJECT
FAX.NUMBER
❑ Architect ❑ Tenant ❑ Agent ❑ Other
( -
NA - PRIMARY PHONE E -MAIL ADDRESS
NAME
Per RCW 19.27.095:
Lender information is required if project value exceeds $5,000
MAILING ADDRESS
CITY, STATE, -ZIP
PHONE
I,
EXISTING USE
EXISTING ASSESSED /APPRAISED VALUE $
SPRINKLERED BUILDING? ❑ YES ❑ NO
PROPOSED USE
VALUE OF PROPOSED WORK $
FIRE SUPPRESSION SYSTEM PROPOSED / REQUIRED? ❑ YES ❑ NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL)
SEWER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE (SEPTIC)
1111.a.ft LGoWurIlull
EXISTING
S . FT.
PROPOSED
S . FT.
TOTAL
BASEMENT
o YES o NO.
,
FIRST
ZONING DESIGNATION
.SECOND
o NO
NEW ADDRESS REQUIRED?
o YES o NO
THIRD
UP /SEPA /SU? o YES
o NO
PLATTED LOT?
ADDITIONAL FLOORS (DESCRIBE)
DEMO PERMIT REQUIRED? a YES
o NO
DECK-(0 COVERED OR ❑ UNCOVERED ?)
GARAGE ❑ CARPORT ❑
NUMBER OF FLOORS
rnorosu
Tone,
rorAt, z=rnro sr
TOTAL PAMPOBao sr '
ror/u. sr
"NEW HOMES ONLY" NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
Indicate number of each type of fvcture to be installed or relocated as part'of this project. Do not include existing fixtures to remain
MECHANICAL
Value of Mechanical Work $ O (A COPY OF BID OR ESTIMATE MUST BE INCLUDED WrtH APPLICATION)
AIR HANDLING UNITS EVAPORATIVE COOLERS _�_ GAS PIPE OUTLETS WOODSTOVES
BBQS . FANS GAS WATER HEATERS MISC (Describe)
BOILERS FIREPLACE INSERTS HOODS tcommera4
COMPRESSORS FURNACES- RANGES
DUCTS GAS LOG SETS REFRIG. SYSTEMS
PLUMBING
BATHTUBS (or Tab /shower combo► LAV.S pathr m swc4 URINALS MISC (Describe)
DISHWASHERS RAINWATER SYST VACUUM BREAKERS
DRINKING FOUNTAINS SHOWERS WATER CLOSETS (roueq
ELECTRIC WATER HEATERS SINKS WASHING MACHINES
HOSE BIBBS SUMPS
I certify under penalty of perjury that the ir4 formation furnished by me is true and correct to the best of my knowledge, and further, that I
am authorized by the owner of ,the above premises to perform the work for which the permit application is made. I further agree to hold
harmless the City of Federal Way as to any claim (including costs, expenses, and attorneys' fees incurred in the investigation and defense of
such Clair 4, which may be made by any person, including the undersigned, and filed against the City of Federal Way, but only where such claim
arises out of the reliance ojthe city, including its officers and employees, upon the accuracy of the information supplied to the city as a part of
this application.
NAME /TITLE
tz:;ignawre)
PROJECT ❑ Owner ❑ Agent )Contractor
DATE
❑ Architect ❑ Other
o NEW o ADDITION
o ALTERATION
o REPAIR o TENANT IMPROVEMENT
BUILDING SHELL ONLji?
o YES o NO.
BASIC PLAN? o YES
n NO
ZONING DESIGNATION
CHANGE OF USE? o. YES
o NO
NEW ADDRESS REQUIRED?
o YES o NO
UP /SEPA /SU? o YES
o NO
PLATTED LOT?
o YES o NO
DEMO PERMIT REQUIRED? a YES
o NO
r
Bulletin #100 —April 2, 2007 . Page 2 of k \Handouts\Permit Application